Thoracoscopic pulmonary surgery.

Thoracoscopy in infants and children has undergone a dramatic evolution in the last 30 years. From its infancy in the mid-1970s, limited procedures such as biopsy and pleural lysis, were pioneered by Rogers and others, and in the late 1990s, the most delicate of procedures, a tracheo-esophageal fistula repair, was performed thoracoscopically for the first time. During the last 20 years, it has become clear that the most commonly performed thoracic procedures in the pediatric age group, lung biopsy and resection, are clearly best performed using these advanced thoracoscopic techniques. New instrumentation and advanced skills now make thoracoscopic lung resection the preferred approach and help avoid the significant morbidity associated with thoracotomy in the pediatric age group.